Chiropractic / Musculoskeletal / Joint pain Q & A...

[ScottyDoc]

Hey guys, I have introduced myself before, but I will do so again. My name is Dr. Albert Scott and I am a licensed, board certified Chiropractor in Atlanta, GA. I am currently REPing for REDEFINE NUTRITION on this Forum, but that is not the point of this thread.

I have created this thread in an effort to offer my services in the form of advise on any sports related injuries, specifically musculoskeletal &/or joint pains. So please feel free, if you have any questions I promise to give my professional opinion and do my best to guide you in the proper direction of recovery.

[ken22]

I have a question. I have elbow pain. right on the tip of the Funny Bone. Hurts when I do overhead tris but not pushdowns. hurt about 3 to 4 weeks ago. I think I actually hurt it by bumping it on something at the gym. what do u think. I also have typical tendonitize in that elbow also.

[waynaferd]

just to the right side of my spine, above the butt bone....I do P90X stretches and one where I roll my ass around on a small ball, and that helps, but I still get the pain on the side....

Any ideas?

[ScottyDoc]

I have a question. I have elbow pain. right on the tip of the Funny Bone. Hurts when I do overhead tris but not pushdowns. hurt about 3 to 4 weeks ago. I think I actually hurt it by bumping it on something at the gym. what do u think. I also have typical tendonitize in that elbow also.

Does it hurt now, or are you saying you injured it 3-4 wks ago?

Hard to explain why it would hurt with overhead tri's and not press downs, my only assumption there is... and also you say it occurred from bumping the funny bone region, sounds like a deep tendon bruise and considering their are 3 heads to the tricep, the one you bruised is not as actively used when doing tricep press downs vs. overhead tricep exercises. OK, so your tricep attaches to the olecranon process of the ulna bone (elbow). The funny-bone location is on the lateral aspect of your elbow, where the lateral head of the tricep attaches.

Again, just sounds like a bruise, I would contrast between heat and ice, also stretch while heating and massage while icing. Do 15mins of one, then 15mins of the other and you can continue that cycle for as long as you want, I would just always recommend you end with ice, unless it is just prior to a workout, in that case, end with heat so your muscle and tendon are warm and more elastic.

I hope this helps, unless you suffered a worse blow to your elbow (funny-bone) than you are letting on, I would not assume anything is broken or torn.

[ScottyDoc]

just to the right side of my spine, above the butt bone....I do P90X stretches and one where I roll my ass around on a small ball, and that helps, but I still get the pain on the side....

Any ideas?

Ok, so from what you are telling me it sounds like you are having pain over your PSIS (posterior superior iliac spine). The PSIS is where your right hip connects with your sacrum, what I am assuming you are calling your butt bone. It is a very common articulation (joining of two bones) to become misaligned and put pressure on a nerve and for a lack of better words, hurt like a Fother Mucker.

How did you injure it, how long has it been hurting and is it getting better or worse as time goes on?

It honestly sounds like you need a chiropractic adjustment my friend, unfortunately it does not sound like something you can just heat, ice and stretch away, not that those will not help the healing process and decrease pain and inflammation once the bone is adjusted into it correct position, but a good adjustment sounds like what you need my friend.

Do you know of a good Chiro in your area?

[MAxximal]

Dr Scott what do you recommend for muscle sores apart of (Glutamine,BCAA and REST)

[celc5]

waynaferd,
it could also be an instability issue with your SI joint. In which case, stretching would be counter productive. But it'd be tough to diagnose over the interweb in your case You'll probably need to be evaluated as Scott suggested

[bluehealer]

Quite nice of you to put up this tread Dr. Scott!

I was just questioning another member about a pain I get in my spin/pelvis joint when squating. It doesn't happen every time but it's is pretty often. It's like dead center of the tailbone area. At the bottom of the squat, more so when pushing up.

[ScottyDoc]

Dr Scott what do you recommend for muscle sores apart of (Glutamine,BCAA and REST)

Heat is always good pre-workout... whether you spend a few mins in the sauna, or get on the treadmill some other type of cardio. No matter which route you choose... approx. 15mins. You can also do it after you work out, but later I would definitely look to ice the area stressed that day/workout in the gym.

Ice is good for post workout never pre, do not wanna try and workout when cold. Also, it is always good for any type of injury or soreness. Also, contrasting the two, heat/ice 15mins each, always end with ice, doesn't necessarily matter which you start with, as long as you end with ice, helps to reduce the inflammation process.

Just something to remember, soreness is similar to an injury in the sense that it is caused by wanted micro-trauma to the muscle fibers (normal occurrence with a good workout), which must heal and when they do heal they heal bigger and stronger and over time, this is how we get muscle & strength gains. Anyway, I explained all this so it is understood that muscle soreness can be treated the same way as an actual injury (macro-trauma)

As far as supplements are concerned, absolutely the ones you mentioned above, some others that are good with both micro & macro-trauma is MSM, Glucosamine, Chondroitin, & EFA's (Omega 3-6-9).

I hope these simple yet effective methods help.

[ScottyDoc]

Quite nice of you to put up this tread Dr. Scott!

I was just questioning another member about a pain I get in my spin/pelvis joint when squating. It doesn't happen every time but it's is pretty often. It's like dead center of the tailbone area. At the bottom of the squat, more so when pushing up.

Happy to help my friend. OK, so when you say your tailbone, do you mean the very small of your back? (put your hands on your hips at the level of your waist/pant line with your thumbs pointing towards your back, slide thumbs back until they touch, this is the approximation of the small of your back give or take 1/2 inch above/below) Or, is it lower? What I consider my tailbone to truly be is my coccyx, which is the very lower tip of my spine, about 1/2 inch above my rectum, then right above that is your sacrum which connects to your pelvis on either side and your last moveable vertebrae, L5 above it. Try to describe exactly where your pain is on this picture I am posting below, will help me!

[vidapreta]

ScottyDoc a few years ago i had a buldging disc in my neck that was pinching a nerve which was causing this pins and needle feeling running from my neck down my arm to my thumb and back up again throughout the day. I did the physical therapy thing for awhile and it eventually went away for the most part. My neck is always sore and feels cracky/crunchy. I always have the urge to crack it but my chiropractor only wants to put me on that machine that pulls my chin back to open the space between the discs. Should i go to another chiropractor to get a neck adjustment?

[bluehealer]

From your description, I would say the sacrum area. About where the butt cheeks start, where the lowest set of nerves are in the picture.

[ScottyDoc]

From your description, I would say the sacrum area. About where the butt cheeks start, where the lowest set of nerves are in the picture.

OK, next Q... Does it hurt dead center or on one side or the other? If it is dead center (most common) it could be a number of different issues between your lumbosacral joint (joint between L5 & Sacrum). If it is on either side then it could be a number of different issues between your right or left sacroilliac joint (joint between sacrum and pelvis).

All this is just helping me diagnose the problem the same way I would do if you were coming into my clinic, which would only take a few minutes of talking to you and a little palpation of the area. Either way, from what you are telling me, it is involving one of the two described joints, I would say that is a chiropractic issue and you should go see a chiropractor. Yes, ice, heat, stretching, & massage would all help with the pain and inflammation as well as the healing process, but would not resolve the original issue, which I believe is a subluxation (misalignment of the joint putting pressure on the nerve).

I just wish I could give cyber adjustments for an extremely discounted price, I would be racking up the $$$, LOL

One thing I will do my best to explain because it is a commonly asked question is, why does it always seem to come back and happen in the same place. My best explanation for this is... it is a pre-disposed area of injury, as in it is a weaker joint/articulation due to previous injury and if all the other surround joints are stronger and you are lifting a lot of weight or exerting yourself, it is going to give before the others. So even after correction, it should always be focused on as an area that always needs proper warming pre-workout, proper icing-post workout, and always listen to your body when trying to push the envelope in order to prevent future injuries. Also, additional strengthening exercises should be incorporated in order to strengthen this weakened area of the body the same way pitchers always warm up their arms/shoulder pre-pitching, ice their arm/shoulder post-pitching and strengthen all the muscles in and around their shoulder (glenohumeral joint).

I hope all this makes sense to you and helps you, low back pain (LBP) can be a bitch, the best way I can describe it to people who have never experienced it, "it makes you feel like an old man" like as if you instantly put 20yrs on yourself. When in severe LBP you will look, act and walk like you are 20yrs older than you are!

[bluehealer]

It's dead center. It's an unusual pain, nothing like I've ever felt before but not unbearable. I can push through and when I'm done with that exercise I'm fine. I do have the occasional pinched nerve in my left hip but I've been doing stretches and hadn't had one of those in over a year.

[JohnRock]

OK, I'll take a turn if you have time...I've been pulling something in my traps just about every time I try to shoulder press any kind of serious weight. It keeps happening, I'll take a week or two off, then ease back in and it'll happen again. Sometimes I can't even feel a specific time when it "pulls" but after the workout, it just starts hurting more and more. The pain feels mostly in my my trap area, but when I turn at the wrong angle, it can extend up into my neck and over to my right shoulder as well. Any ideas?

[bluehealer]

OK, I'll take a turn if you have time...I've been pulling something in my traps just about every time I try to shoulder press any kind of serious weight. It keeps happening, I'll take a week or two off, then ease back in and it'll happen again. Sometimes I can't even feel a specific time when it "pulls" but after the workout, it just starts hurting more and more. The pain feels mostly in my my trap area, but when I turn at the wrong angle, it can extend up into my neck and over to my right shoulder as well. Any ideas?

My unprofessional opinion, pinched nevre in the neck. Get an adjustment.

How'd I do Scottydoc?

[ScottyDoc]

OK, I'll take a turn if you have time...I've been pulling something in my traps just about every time I try to shoulder press any kind of serious weight. It keeps happening, I'll take a week or two off, then ease back in and it'll happen again. Sometimes I can't even feel a specific time when it "pulls" but after the workout, it just starts hurting more and more. The pain feels mostly in my my trap area, but when I turn at the wrong angle, it can extend up into my neck and over to my right shoulder as well. Any ideas?

Ahhh, you are in luck, I have personally had this issue happen to me. It sounds like a problem with you SCM (sternocleidomastoid muscle) named so because it attaches to your stermum, clavicle, & mastoid bones. It is almost impossible to do any kind of shoulder or trapezius movement without flexing this muscle, it is a very strong muscle, one of the primary muscles used to rotate your head from side to side. It could be one of a few things to be honest, do you ever notice when doing your shoulder presses the posture of your head and neck? I have come to realize that mine will occur when my head is not looking exactly straight forward &/or my neck is slightly flexed laterally to the right, mine always happens on the right as well, probably because I am right handed, which considering you are pointing to your right side and also because 80% of the population is right handed that you are as well.

OK, now that we are pretty sure of what is going on and why, let's talk about ways to correct and prevent this situation. Just like every other injury, I suggest heat pre-workout and ice post-workout. More importantly, you need to start doing some neck flexion & extension exercises, lateral neck flexion exercises, and head/neck rotational exercises to strengthen this pre-disposed area of weakness and prevent this from happening in the future.

Unfortunately, the saying that "You are only as strong as your weakest link" applies here and that is your weak link, so if it is not hurting now, maybe take like two weeks off of shoulder and trap exercises and in while you are refraining, do neck strengthening exercises every 3rd day, starting very light for high reps and slowly, I mean slowly increase the weight never doing too heavy of a weight where you can't complete 15 reps.

So exercises: with mild resistance... (4 sets of 15 reps each exercise every 3rd day)
- head flexion (head forward)
- head extension (head back)
- lateral head flexion (ear to shoulder R & L)
- head rotation (rotating head to look R & L)

* not a bad idea to use heating pad to warm up neck before doing this, or sit in hot tub or sauna and stretch your neck out while warming it just prior to neck exercises, if possible!

[JohnRock]

Thanks man! Today was the day I normally do military press/clean & press and I stuck to dumbbell movements for high reps and it's feeling good. I think I'll stick with low weight/high rep for several weeks and start doing the exercises you mentioned. I appreciate the advice!

[ScottyDoc]

My unprofessional opinion, pinched nevre in the neck. Get an adjustment.

How'd I do Scottydoc?

Masta say....Ahhh.... nooo complete-delly coorrect yung grass-hoppa... butt-uhh you-ah thinking.... goood!!!

Aa-hem, excuse me, now to be professional again. You are correct, but it is a little different only because I believe the nerve is getting pinched due to a weak muscle, so always if possible go after the source. From their (correcting the source of your problem) your body will heal itself, for it is an incredible machine designed to do so when the interference is removed.

It boils down to semantics, what came first the chicken or the egg. Did the weakened muscle cause a strain which in turned cause the vertebra to misalign and put pressure on a nerve. or Did the misaligned/pinched nerve cause the muscle spasm and pain? The evidence in my mind would be that it always follows certain exercises, which cause the activation of certain muscles... But, as always, the human body is an incredible and diverse machine that can only be truly mastered when you realize that anything is possible and different things affect different people in different ways.

[ScottyDoc]

Thanks man! Today was the day I normally do military press/clean & press and I stuck to dumbbell movements for high reps and it's feeling good. I think I'll stick with low weight/high rep for several weeks and start doing the exercises you mentioned. I appreciate the advice!

Also, that is you in the picture right... so it looks like you are working out in your basement or something. You can do those exercises one of two ways cheap and easy. If you have someone to help you, have them resist your exercises with a towel or their hand. If you do not have the assistance of someone, then purchase some resistance bands that you can rig up to your wall, can be found for next to nothing on just about any rehab or weight equipment supply store online or even locally if you know of one, they even have them at most sporting good stores here in ATL.